Things Taken (Isabel Hoskins)

Summary: A woman undergoes a hysterectomy to treat ovarian cancer. Though grateful for her survival, she spends her days thereafter mourning the loss of her menstrual periods – “[rhythms], predictable and cyclical and intimate”.

It was October, the thick middle of autumn, when I had my last period. I remember that I bled onto newly washed sheets. I remember eating pears: green and brown and rusted red, juicy in their perfect ripeness. I remember the headache that started at the base of my spine and twisted its knotted fingers around the right side of my skull, boring into my temple and eye socket. I remember my last period because medical arrangements were made around it, and because while I bled that October, I was very afraid.

I had just returned from my midwife’s office where, during my yearly exam, she said she could feel something large and abnormal on my ovary. She told me I needed to make an appointment for an internal ultrasound, that I should get in as soon as possible, but that the test could not be done during my period. I remember sitting at the dining room table, determining where I was in my cycle. The boxes on the calendar, each one with their inked number, said I would begin bleeding in only three days. My appointment was scheduled for that very evening.

Then, for three days, I waited for the results of the ultrasound and waited for my last period, which I did not know would be my last. My family history felt like poisoned soil, infecting the tree that bore our names on branches. So I worried I about things like cancer: uterine, cervical, and ovarian. I told myself not to worry because I was young, only thirty. I did what they tell you not to do and researched on the Internet, typing in my symptoms and reading the results with panic. I passed time at home watching episodes of House on DVD, as if in viewing each rare and strange disease I would become immune to it. I played hours of mah-jong on the computer. I told myself that if I could win just one game before the results came, the news would be good.

My last period started the day we heard from my midwife, and she told me that the ultrasound revealed there was a mass on each ovary and I needed to see a gynecologist in her practice. My husband and I drove to Dr. Saleh’s office an hour later. I was bleeding with my period as we sat in the waning room, and I played solitaire on Todd’s Palm Pilot. I won a game as we sat waiting in the exam room and I told Todd it was a good omen. Not a mah-jong win, but still, it meant something.

Dr. Saleh came in the room and introduced himself. I remember the intoxicating smell of his cologne: pine, cedar, musk, black pepper. He looked at my charts, my results, my body. He said that I had what appeared to be two large cysts, one on each ovary. He said that his opinion was that I should have surgery to remove them as soon as possible, as they were large, the size of oranges and grapefruit, and would likely continue to grow. He said that cysts are benign, but that they can take on a life of their own and sometimes when they remove them, the cysts have hair and teeth growing on them. He said that we should not be worried, that it was quite common to have ovarian cysts, that he was not thinking tumours or cancer and we should not be either. He said he wanted to give me an internal vaginal exam. I told him I was having my period now. He said this was fine, that he was only feeling for the location and size of the cysts. I remember my last period because when he removed his hand from my vagina, the glove was covered in my red menstrual blood and he tried to be discreet while he pulled it off and threw it in the toxic waste bin.

I bled for my normal ten days and during this time I waited for surgery. I remember sitting at my friend’s house, and she asked me if I was scared or worried I told her that, strangely, I was not. I felt like even thing would be fine.

“I’m willing to be surprised,” I said.

My last period ended The bright red blood turned to soft pink and then it was done. The box of tampons went back in the linen closet alongside towels and cotton balls and toilet cleaner. Three days later I was at the hospital for surgery. As they wheeled me into the operating room the anesthesiologist asked me if I wanted a little shot of a relaxant, to soften things around the edges before they officially put me under. I said yes. And then I was out and I don’t remember what happened because I had fallen into the unconscious, abducted into darkness, the last memory I have, Dr Saleh leaning over my bed and smelling so good I could have crawled up and rested in the crook of his neck.

I have no memory of the next eight hours. I have been told that this is what happened. Dr. Saleh began the surgery laparoscopically and once inside he discovered a tumour. They slit my skin apart, a horizontal incision just above my pubic bone. An oncologist was called in for a consult. A piece of the tumour was removed, frozen, and sent for immediate biopsy. It came back malignant . While I was still unconscious and on the operating table, the doctors went out to the waiting room where my husband had been sitting alone in fear, wondering why what was supposed to take two to three hours had now surpassed five. They told him what they had found. He gave them permission to perform a full hysterectomy. They removed uterus, tubes, and ovaries, along with samples from other organs and tissue so they could all be sent to pathology to see if cancer had spread. Successfully emptied, they then sewed my skin back together and when I woke later, in the same room I had been in before they wheeled me into surgery, I looked at the clock on the wall. When it said seven o’clock, hours past when it should have been, I knew something had gone wrong.

Though this is what happened to me, it still feels not mine own. I was not conscious and in the shroud of anesthesia I had no voice or choice. There was not even dreaming. It remains lost time in which, transported to the realm of the unconscious, events unfolded that would change my life. When they cut into my skin and with sterile surgical instruments removed organs and cysts and tumour, they cut open a wound in the ground and, like Persephone abducted into the Underworld by Hades, I slipped underneath.

In the days following, Dr. Saleh and the oncologist came to see me at frequent intervals, telling the same story again and again. I was thirty, so young to have had ovarian cancer. I was amazingly lucky to have had it found in the earliest of stages. I was not to worry because, though we were still waiting for the rest of the results to make sure it had not spread, they found everything so soon and I was so young.

People came to sit with me in the hospital and they said they were sorry and that I was brave. My mom flew out to take care of things at home. My midwife, who had been with me for the birth of my son, cried when she came to see me, The nurses warned me it would take a long time to recover, longer than six weeks for my body to heal. The oncologist reminded me every time she stopped in my room how lucky I was, how remarkable really it was that I figured this out when I did. My husband reminded me, himself, again and again “We were not planning to have more kids anyway.”

The pathology results returned and, except for the tumour and right ovary, they were all negative. A week later I went to see the oncologist and she told me I had been diagnosed with stage 1C ovarian cancer and that I required no further cancer treatments such as radiation or chemotherapy, as all cancer was successfully removed during surgery. She told me I would need to take tumour marker tests every six months for the next several years. She told me I would probably experience depression.

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And then my mom returned home. And then Todd went back to work. And then it was Halloween and I was well enough to walk slowly through the street with my toddler while he went trick-or-treating, the tail of his furry Tigger costume trailing behind. And then I went for the two-week post-surgical checkup with Dr. Saleh. Cancer free. Lucky. The incision healing well, quickly, faster than expected. And then the ground closed over me, from that place where I descended, and the grass grew over what had been a gaping wound and it was still, as if nothing ever happened.

I recovered, regained strength, and resumed normal responsibilities. I had not planned on having more children anyway. I was fortunate. I had known worse things than the loss of my reproductive organs. I was grateful for my life, my husband, my health, my son. I was so young, only thirty, and my body could bounce back. If it were not for my absent menstrual cycle, I could pretend everything was normal.

I tried to make the most of things and went shopping for all new underwear, pretty delicate things that would never be stained with blood because I miscalculated the beginning of period or went out without bringing an extra tampon. That was it then. My consolation for losing my uterus and estrogen, for being cut open and stripped of organs, was twelve new pairs of panties. The absurdity slapped me and I felt a stinging burn through my body. Back home, looking through my purchases, I started crying. I did not stop. In the thicket of the unconscious and unspoken, in my fears and feelings that oozed and wormed their way into my dreams, in the images that arose from the part of me still locked against my will in that place to which I had descended, I began to grieve.

It was in the terrain of my flesh, with its scar ripping across my lower abdomen with its absence of estrogen and progesterone, with its memory, that I found the way to mourn and tell my story, At times the grief felt like an emptiness, a void, barren as my removed womb. Where I once felt fertile creativity, there was vacancy. Absence itself came to take up space. My body began to dry out. I watched my hair change texture and turn to frizz, refusing to hold soft curls. My skin revealed its parched patches, flaking as if they had seen the scorch of desert heat. I found myself unable to wear contact lenses because even my eyes had lost their slippery wetness. Sometimes in the arid starkness of loss it felt as if nothing could grow on such a desolate land. My body taught me how to grieve.

It has been a year since my last period. I am still grieving. I grieve what I have lost and what has been given: the innocence of believing that youth equals health, the baffling realization I had cancer and it was both discovered and eradicated all while unconscious, the absence of my reproductive organs and the hormones that affect more than I had imagined, the ability to have a choice in whether or not I would have another child birthed from my body, the doctor visits that clutter my calendar, that vulnerability of having my insides touched and parts of me taken. And this: I miss my period.

It happened so suddenly, with no warning of its departure, and I miss my periods. I miss bleeding once a month I miss the movement of feelings, the undulation of energy and creativity and how, though always fluctuating, it followed a rhythm, predictable and cyclical and intimate.

My periods have left me. Weeks pass, months pass, seasons shape shift, and I no longer know this in my body as I once did. For eighteen years menstruation has been the way I tell time, the circling of ovulation and emptying. It is more to me than just a physiological process of egg descending down the tube, of the lining on the uterus growing thick and webbed, ready to sustain new life, of the shedding of blood that has been considered to be both sacred and unclean. For me, having my period was how my body spoke to me and how I began listening. The entire life cycle was found with my own flesh, the beginning and ending and beginning again. I miss my periods, the shedding of blood like snakes slithering out of their skin.

Time passes. I move on. but not as I once was. In the shadow of fecundity is that which destroys and takes from us in its descent, returning us to the womb so we might begin again. Even without my periods a life cycle remains in me. As Persephone heralding

the first stirrings of spring, I walk again upon the earth. The Underworld does not leave me but comes with me, rooted in my body as I grieve its wounds. I feel the physical manifestations of menopause and the emotional aftermath of being cut open, with its grief and anger and gratitude for saving me, and I watch myself fuse back together, the way my skin did as it healed from its surgical wound.

It is October once again and there are pumpkins and squash and the first pomegranates of the season with the thick, husk-like skin puckered up at the top like a kiss, the lumpy roundness, the hidden nest of seeds. I buy one and bring it home, slicing through the middle where it then falls into two halves and a tiny stream of juice drips onto the counter. Inside is a mine of jewel-toned seeds, each one a morsel of tart sweetness, beginning with a delicate crunch and softening into liquid centre. There is no real fleshy meat. The seeds are the meat, the prize, the delicacy, the red gift. And there are so many, too many to count, and they remind me of my lost eggs from my lost ovaries that were once inside my body and now are no longer. I pull the seeds out with my fingers, disentangling them from the webbed centre. They feel like pearls, smooth, but if you put them in between your teeth, you can feel their gritty beginnings. I eat the seed, swallow it whole.

1. Comment on the narrator’s description of being anesthetized and undergoing surgery: “Under the shroud of anesthesia, I had no voice or choice…they cut open a wound in the ground and like Persephone abducted into the Underworld by Hades, I slipped underneath.”

2. Even as the narrator grieves the loss of her uterus, her story abounds with imagery of fertility and growth. The ending scene is one of a spring landscape, with “pumpkins and squash and the first pomegranates of the season.” What do you make of this seemingly contradictory interplay of images?

3. The narrator points out how her doctors’ optimism about her good prognosis is out of line with her own bleak view of having ovarian cancer. Do we impose unnecessary pressure on patients by insisting they see things in a positive light? What are alternative strategies to address this discord between the biomedical and patient views of illness?